| NPI | 1629629340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY TANNER BELL CEO 757-827-2480 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2024-04-05 |